title: Primary aldosteronism: emerging trends.
abstract: Primary aldosteronism (PA) is the most common etiology of endocrine hypertension (HTN), and recent prevalence studies suggest that it may be under-diagnosed. Indications for screening have been expanded with recognition that many patients with PA do not have hypokalemia and that the disease may be familial. The aldosterone:renin ratio (ARR) is the preferred screening test for PA. The ARR can be interpreted in patients on most anti-hypertensive agents, and can be used to guide medical therapy of HTN even in patients without PA. Once PA is confirmed, adrenal venous sampling (AVS) should be performed to determine if PA is due to bilateral disease or a unilateral adenoma, if surgery is being considered. Targeted medical or surgical therapy improves patient outcomes.
authors.affiliation: Division of Endocrinology, Metabolism and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, Adrenal Center at Mount Sinai Hospital, 1 Gustave L. Levy Place, #1055, New York, NY 10029, USA.
authors.forename: Sandi-Jo
authors.initials: SJ
authors.lastname: Galati
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Hopkins
authors.forename: Khadeen C
authors.initials: KC
authors.lastname: Cheesman
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Zhuk
authors.forename: Alice C
authors.initials: AC
authors.lastname: Levine
mesh_terms: D000450:Aldosterone / Q000097:blood*; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D006973:Hypertension / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D007008:Hypokalemia / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D012083:Renin / Q000097:blood*
chemical_list: D000450:Aldosterone; D012083:Renin
keywords: aldosterone; hypertension; primary aldosteronism; renin; resistant hypertension